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63 Cards in this Set

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  • Back
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What are the two types of partial seizures
Simple and complex
What are the three types of general seizures
Tonic-clonic, absence, and myoclonic
What is another name for tonic-clonic seizures
Grand mal seizures
What is another name for absence seizures
Petit mal seizures
Does hypoventilation or hyperventilation lower the seizure threshold
Hyperventialtion (via alkalinization of blood pH)
What is the most common seizure type
Tonic-clonic seizure
What type of seizure is associated with “febrile seizures”
Tonic-clonic seizure
What type of seizure most commonly presents during childhood
Absence seizure
What is status epilepticus
Epileptic seizure lasting longer than 30 minutes or absence of full recovery of consciousness between seizures (can be life threatening)
In general, how do antiepileptic agents work
Inhibit initiation of an abnormal electrical discharge from the focal area; prevent dissemination of abnormal electrical discharge to surrounding areas of the brain
What is the mechanism of action of phenytoin
Inhibition of axonal sodium channels to produce membrane stabilization
Does phenytoin inhibit the axonal sodium channel in its activated or inactivated state
Inactivated state
What antiarrhythmic class does phenytoin belong to
Class Ib
What type of drug interactions can phenytoin produce
Induces cytochrome P-450 metabolic enzymes; highly protein bound, therefore, can potentially displace other medications from plasma proteins
What are the adverse effects of phenytoin
Diplopia
Sedation
Ataxia
Gingival hyperplasia
Acne
Hirsutism
Megaloblastic anemia (interferes with folate absorption)
Granulocytopenia
Hypotension (IV)
Osteomalacia
Drug-induced lupus
Hyperglycemia
Nystagmus
Stevens-Johnson syndrome
Hepatotoxicity
None
Is phenytoin safe to use during pregnancy
No (causes fetal hydantoin syndrome characterized by cleft lip and palate)
What prodrug is hydrolyzed to phenytoin and is commonly given intravenously secondary to its superior water solubility vs. phenytoin
Fosphenytoin
What is the acronym for phenytoin
DPH (diphenyl hydantoin)
Name two other medications that may cause gingival hyperplasia
Cyclosporin A
Nifedipine
None
Which types of seizures does phenytoin treat
Partial
Tonic-clonic
Status epilepticus
None
What is the mechanism of action of carbamazepine
Inhibition of axonal sodium channels to produce membrane stabilization
What type of drug interactions can carbamazepine cause
Induces cytochrome P-450 metabolic enzymes
Autoinduces its own metabolism
None
What conditions, other than epilepsy, can carbamazepine be used in
Manic-depression
Trigeminal neuralgia
None
What are the adverse effects of carbamazepine
Diplopia
Sedation
Ataxia
Osteomalacia
Aplastic anemia
Hyponatremia
Stevens-Johnson syndrome
Alopecia
Pancreatitis
Hepatotoxicity
Nystagmus
None
Is carbamazepine safe to use in pregnancy
No (neural tube defects and craniofacial abnormalities)
None
How does carbamazepine cause hyponatremia
Syndrome of inappropriate antidiuretic hormone
Which types of seizures does carbamazepine treat
Tonic-clonic
Simple partial
Complex partial
None
What antiepileptic medication can cause alopecia
Valproic acid (VPA)
What is the mechanism of action of valproic acid (VPA)
Inhibition of axonal sodium channels
Inhibition of T-type calcium channels
Inhibition of GABA transaminase
None
What type of drug interactions can VPA produce
Inhibition of cytochrome P-450 enzymes
What conditions, other than epilepsy, can VPA be used in
Manic-depression
Migraine
None
What are the adverse effects of VPA
Hepatotoxicity
Pancreatitis
Alopecia
Nausea
Vomiting
Photosensitivity
Sedation
Diarrhea
Abdominal pain
Thrombocytopenia
Rash
Amenorrhea
Dysmenorrhea
Weight gain
Tinnitus
None
Is VPA safe to use in pregnancy
No (neural tube defects)
Which types of seizures does VPA treat
Tonic-clonic
Simple partial
Complex partial
Absence
Myoclonic
None
Which antiepileptic medication is used to treat partial and tonic-clonic seizures during pregnancy
Phenobarbital
Phenobarbital is an active metabolite of which medication
Primidone
What is the second active metabolite of primidone
Phenylethylmalonamide (PEMA)
Which benzodiazepines are used in the treatment of status epilepticus
Diazepam; Lorazepam
Which benzodiazepine is used to treat myoclonic and absence seizures
Clonazepam
Which antiepileptic medication is the drug of choice for treating absence seizures and its only FDA indication is for absence seizures
Ethosuximide
What is the mechanism of action of ethosuximide
Inhibition of T-type calcium channels in the thalamus
What are the adverse effects of ethosuximide
EPS
Nausea
Vomiting
Diarrhea
Abdominal pain
Fatigue
Hirsutism
Stevens-Johnson syndrome
Drug-induced lupus
Hiccups
None
What medication may be used to treat intractable hiccups
Chlorpromazine (antipsychotic)
None
Which antiepileptics decrease the efficacy of oral contraceptives
Phenytoin; Carbamazepine
How do phenytoin and carbamazepine decrease the efficacy of oral contraceptives
Induction of cytochrome P-450 enzymes
Overdose or abrupt withdrawal of antiepileptics may cause what adverse effect
Seizures
Give examples of antiepileptic medications
Phenytoin
Carbamazepine
Oxcarbazepine
Phenobarbital
Gabapentin
Tiagabine
Levetiracetam
Felbamate

Ethosuximide

Valproic acid
Lamotrigine
Topiramate
Zonisamide

Lorazepam
Diazepam
Fosphenytoin

Vigabatrin
Corticotropin
Prednisone
None
Name two antiepileptics that are considered free of drug-drug interactions
Gabapentin
Levetiracetam
None
Which of the newer antiepileptics may inhibit carbonic anhydrase thereby causing a metabolic acidosis
Topiramate
What conditions, other than epilepsy, can topiramate be used in
Migraine
Manic-depression
Neuropathic pain
None
What is the mechanism of action of topiramate
Inhibition of glutamate (AMPA) receptors
Increases GABA effects
Blocks neuronal voltage-gated sodium channels
None
Which types of seizures does topiramate treat
Partial
Seizures associated with Lennox-Gastaut syndrome
None
What are the adverse effects of topiramate
Impaired cognition
Word finding difficulty
Sedation
Weight loss
Renal stones
Metabolic acidosis
None
Which of the newer antiepileptics may cause Stevens-Johnson syndrome
Lamotrigine
What is the mechanism of action of lamotrigine
Inhibition of sodium channels
Inhibition of glutamate receptors
None
Which types of seizures does lamotrigine treat
Partial
Absence
Seizures associated with Lennox-Gastaut syndrome
None
What are the adverse effects of lamotrigine
Stevens-Johnson syndrome
Sedation
Headache
Dizziness
Ataxia
Nausea
Diplopia
Amenorrhea
Dysmenorrhea
None
What neurotransmitter is gabapentin structurally related to
GABA
Does gabapentin bind to the GABA receptor
No
What is the mechanism of action of gabapentin
Unknown (may bind to voltage-gated calcium channels specifically possessing the α-2-δ-1 subunit)
Which types of seizures does gabapentin treat
Partial
None
What conditions, other than epilepsy, can gabapentin be used in
Neuropathic pain
Anxiety
Migraine
Trigeminal Neuralgia
None
What are the adverse effects of gabapentin
Peripheral edema
Behavioral and thought disorders in children aged 3-12
Sedation
Ataxia
Viral infection (in children)
Weight gain
Diarrhea
Nausea
Vomiting
None